Healthy Steps (National Evaluation 1996 Protocol) Meets HHS Criteria

This report focuses on Healthy Steps as implemented in the 1996 evaluation. HHS has determined that home visiting is not the primary service delivery strategy and the model does not meet current requirements for MIECHV program implementation.

Model effectiveness research report last updated: 2011

Effects shown in research & outcome measure details

Child development and school readiness

Findings rated high

Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
MCDI combines two or more words (sometimes/often versus not yet)
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 219 children Mean = 0.93 Mean = 0.89 OR = 1.05 HomeVEE calculated = 0.03 Statistically significant,
p < 0.05
MCDI use of two-word endings (three or more versus less than three)
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 219 children Mean = 0.55 Mean = 0.55 OR = 1.09 HomeVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
MCDI vocabulary checklist
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 219 children Mean = 54.40 Mean = 52.30 Mean difference = 4.08 Not available Statistically significant,
p < 0.05
MCDI word length of child’s 3 longest phrases
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 219 children Mean = 4.29 Mean = 4.57 Mean difference = -0.22 Not available Not statistically significant, p ≥ 0.05
Child Behavior Checklist: Aggressive behavior subscale
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 children Mean = 8.01 Mean = 7.46 Mean difference = 0.54 Not available Not statistically significant, p ≥ 0.05
Child Behavior Checklist: Anxious or depressed mood subscale
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 children Mean = 4.12 Mean = 3.71 Mean difference = 0.40 Not available Statistically significant,
p < 0.05
Child Behavior Checklist: Sleep problems subscale
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 children Mean = 3.35 Mean = 2.88 Mean difference = 0.39 Not available Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

CBCL: Anxious or depressed mood subscale

The CBCL is a questionnaire that assesses behavioral problems in young children. The researchers used three subscales, which used aggressive behavior (15 items with a subscale score range of 0 to 30), sleep problems (7 items with a subscale score range of 0 to 14), and symptoms related to an anxious or depressed mood (11 items with a subscale score range of 0 to 22).

Parent/caregiver report

Cronbach’s α = 0.68

CDI word length of child’s three longest phrases

The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases.

Parent/caregiver report

Not reported by author

CDI use of two-word endings (three or more versus less than three)

The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases.

Parent/caregiver report

Not reported by author

CDI vocabulary checklist

The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases.

Parent/caregiver report

Not reported by author

MacArthur CDI combines two or more words (sometimes/often versus not yet)

The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases.

Parent/caregiver report

Not reported by author

Findings rated moderate

Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Attachment Q-sort scale
FavorableUnfavorable or ambiguousNo Effect
16-18 mo. 2 of the 6 RCT national evaluation sites 378 children Mean = 0.37 Mean = 0.36 Mean difference = 0.01 Not available Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

Attachment Q-Sort scale

The Attachment Q-Sort assesses security of attachment and dependency in young children. Each of the 90 items is a description of a specific behavior. Items are sorted by the mother/caregiver into nine piles of 10 cards each based on how likely or unlikely the item matches the behavior of her child. Parent/caregiver report with the assistance of a trained interviewer

Not reported by author

Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Clinical or borderline concern about child behavior
FavorableUnfavorable or ambiguousNo Effect
5.5 years The 6 RCT national evaluation sites 1308 children Mean = 0.20 Mean = 0.17 OR = 1.26 HomeVEE calculated = 0.14 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

CBCL: Clinical or borderline concern about child behavior

The CBCL is a questionnaire that assesses behavioral problems in young children. Parent/caregiver report

Not reported by author

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